1. Field of the Invention
The invention relates generally to enteral tubes and more particularly to mechanical connections between enteral tubes and feeding sets containing food or medication.
2. Description of the Related Art
Enteral tubes for providing food and medication to a patient are well known. For example, U.S. Pat. No. 4,666,433, entitled Gastrostomy Feeding Device, invented by Parks and issued May 19, 1987; and U.S. Pat. No. 4,701,163, entitled Gastrostomy Feeding Device, invented by Parks and issued Oct. 20, 1987; and U.S. Pat. No. 4,798,592, entitled Gastrostomy Feeding Device, invented by Parks and issued Jan. 17, 1989; and U.S. Pat. No. 4,685,901, entitled Gastro-Jejunal Feeding Device, invented by Parks and issued Aug. 11, 1987 disclose earlier feeding tubes.
Referring to the illustrative drawing of FIG. 1A, there is shown a perspective view of an earlier enteral feeding device 20. The device 20 includes an elongated tubular member 51 formed from a stretchable elastomeric material such as silicone. FIG. 1B is an illustrative cross-sectional view of the tubular member 51 of the earlier device. The member 51 defines a jejunal tube 22, a gastronomy tube 34 and a fluid line 46.
The jejunal feeding tube 22 includes an outlet end portion 24 which can extend through a patient's stomach into the jejunum. The jejunal tube outlet end portion includes perforations 26 which permit liquid food or medication to pass therethrough. The tube 22 is integrally connected to a jejunal tube inlet end portion 28 which defines a jejunal inlet port 30 having a removable plug cover 32.
The gastrostomy tube 34 is shorter than the jejunal tube 22 and includes a plurality of drainage inlets or food outlet ports such as inlet/outlet 36. A gastrostomy tube end portion 37 defines a gastrostomy inlet port 38 having a plug cover 40.
An inflatable balloon 42 is provided near the end of the gastrostomy tube 34 and is inflatable through a valve 44. The valve 44 is used to supply fluid to the balloon 42 through the fluid line 46.
Frictional contact between the elongated tubular member 51 and a locking ring 56 is sufficiently great to prevent the member 51 from moving further into the stomach. The locking ring 56 to remains in contact with a patient's abdominal wall during use. However, the frictional contact also is sufficiently low to permit adjustment of placement of the member 51 relative to a patient's abdomen.
Referring to the illustrative drawings of FIG. 2, there is shown a perspective view of an earlier device 20 in use. The inflated balloon 42 forms a gasket that seals the entrance to the stomach, and together with the locking ring 56, secures the device 20 in place.
While prior feeding tubes generally have been acceptable, there have been shortcomings with their use. In particular, for example, in order to provide food or medication to the jejunal inlet port 30 of device 20, a connector, such as a first connector 58 illustrated in FIG. 3 or a second connector 60 illustrated in FIG. 4, is inserted through the jejunal inlet port 30. The inserted connector 58 or 60 is mechanically coupled to the jejunal inlet port 30 and serves as a conduit between the jejunal tube 22 and an external feeding tube 62 or 64, shown in FIGS. 3 and 4. The external tube 62 or 64 is connected to a source of food such as a feeding bag (not shown).
In practice, connectors 58 or 60 such as those shown in FIGS. 3 and 4, for example, may be inserted into and removed from the jejunal inlet port 30 or the gastrostomy inlet port 38 numerous times during the course of use of the device 20 which can be installed in a patient's stomach for extended periods of time. As mentioned above, the member 51 which defines the jejunal tube inlet end 28, and the gastrostomy tube end portion 37 can be formed from a stretchable elastomeric material such as silicone. In order to produce an adequate mechanical coupling between the connector 58 or 60 and either the jejunal inlet port 30 or the gastrostomy inlet port 38, the connector is forced into place so as to produce a frictional engagement. Repeated insertions and removals of such connectors 58 or 60 can cause the jejunal inlet port 30 or the gastrostomy inlet port 38 to become somewhat stretched and deformed over time.
Unfortunately, as the jejunal and gastrostomy inlet ports 30, 38 become more and more stretched in this manner, the tendency of a medical attendant responsible for coupling such a connector to the inlet ports 30,38 often is to more forcibly push the connector into the jejunal or gastrostomy ports 30 or 38 resulting in still further stretching. Moreover, more force often must be exerted to dislodge a connector after such a forced insertion. Additionally, as the interior of the inlet ports 30, 38 becomes soiled with food oils, for example, an attendant may attempt to push a connector into the port even more forcibly in order to compensate for the slipperiness of such oils, causing further deformation of the port opening.
The problem of achieving a tight fit between a jejunal or gastrostomy inlet port 30 or 38 and such connectors 58 or 60, for example, has been exacerbated by the fact that in the past, such connectors often have been available in a variety of shapes and sizes. This variety will be apparent from the illustrative drawings of FIGS. 3 and 4 in which the first and second connectors 58, 60 have quite different shapes. Consequently, in the past it often has been desirable to construct jejunal or gastrostomy inlet ports, that can accommodate any of a variety of such differently shaped connectors. Unfortunately, such earlier inlet ports often could not readily accommodate such a variety of differently shaped connectors without the need to forcibly insert or forcibly remove the connectors.
Thus, there has been a need for a device to permit any of a variety of different shapes and sizes of connectors to be inserted into or removed from an inlet port of a feeding tube without the need to use excessive force and substantially without deforming the feeding tube inlet port. The present invention meets these needs.